Wound Healing and Scar Patterning After Addition of Autologous Skin Cell Suspension to Meshed Grafts

• Published in: The Journal of surgical research 2024-10, Vol.302, p.925-935
• Main Authors: Collins, Monica L., Williams, Dillon, Pierson, Brooke E., D'Orio, Cameron S., Oliver, Mary A., Moffatt, Lauren T., Shupp, Jeffrey W., Travis, Taryn E., Carney, Bonnie C.
• Format: Article
• Language: English
• Subjects: Autologous skin cell suspension; Burn wound; Duroc pig; Excision wound; Mesh split thickness skin graft; Wound patterning
• ISSN: 0022-4804; 1095-8673; 1095-8673
• DOI: 10.1016/j.jss.2024.08.006

A common treatment for large deep-to-full-thickness burns is excision and grafting with a widely meshed split-thickness skin graft (mSTSG). Due to the differential healing of the interstices and adhered split-thickness skin graft, wound patterning and delayed wound healing are common outcomes of this treatment. Delayed healing may increase infection rates and wound care requirements, while wound patterning may be psychologically and aesthetically consequential for patients. Autologous skin cell suspension (ASCS) can be used to “over spray” a meshed autograft. It was hypothesized that the use of ASCS combined with mSTSG would increase the rate of wound healing and decrease patterning in healed burn wounds. Full-thickness burns or excisional wounds (n = 8 each) were created in red Duroc pigs and received 4:1 mSTSGs after wound bed preparation. Half of the wounds received ASCS and half did not at the time of grafting. Percent re-epithelialization, patterning, rete ridge ratio, cellularity, dermal and epidermal thickness, immunofluorescent S100β staining, and melanin index were assessed for each scar. Wounds that received ASCS exhibited increased rates of re-epithelialization (burn +ACSC versus burn-ASCS; day 3 (53.9 ± 3.1 versus 34.3 ± 3.3, P = 0.009): day 5 (68.1 ± 1.6 versus 40.8 ± 3.2, P